Baptist Health South Florida (Baptist Health) is the largest faith-based, not-for-profit healthcare organization in the region, with a reputation for medical and service excellence. Baptist Health includes seven hospitals—Baptist Hospital, Baptist Children’s Hospital, Doctors Hospital, Homestead Hospital, Mariners Hospital, South Miami Hospital and West Kendall Baptist Hospital—and more than two dozen medical plazas and outpatient facilities, spanning three counties from Broward/Ft. Lauderdale to Miami-Dade to the Florida Keys.
Headquartered in Coral Gables, Florida, Baptist Health is South Florida’s largest private employer, with more than 15,000 employees. More than 2,000 physicians, many with national and international reputations, are affiliated with Baptist Health. Baptist Health also has one of the largest international programs in the country, serving more than 12,000 patients from Latin America and the Caribbean.
Across its service network, Baptist Health has more than 1,600 beds and records over 217,000 emergency room visits, more than 124,000 urgent care visits, and nearly 70,000 patient admissions per year.
Capturing and managing critical data across such a large and fast growing network is a big task. But Baptist Health found an answer with a document capture and enterprise content management (ECM) solution from CGI and ibml. The solution has helped Baptist Health speed turnaround times, lower labor and supply costs, and enhance service to patients and staff.
Baptist Health’s migration to an enterprise content management solution began in 1997 with the implementation of CGI’s Sovera® Health Information Management (HIM) solution. Sovera HIM, built on the IBM Enterprise Content Management System framework, provides the organization with a complete digital document managementand workflow system that expedites the coding and medical chart review process which contributes to a decrease in accounts-receivables and enables JHACO compliance. Sovera’s highly scalable architecture allows Baptist Health to manage multiple facilities and large volumes of patient information simultaneously.
Since the implementation, Baptist Health has expanded its Sovera HIM solution to image-enable its Siemens Life Time Clinical Record so users can view content that has been captured in Sovera from within their clinical system. In addition, Baptist Health and CGI most recently created a new content management repository to capture and store employee health records to help monitor, regulate and respond to employee health and safety incidences and programs.
The need for a more powerful capture solution
Baptist Health currently processes 43,000 pages per day, representing more than 14.5 million pages annually. Faced with significantly higher data volumes as a result of a 133-bed hospital that opened in 2011, plus the need and demand to begin scanning documents from other departments across the organization, Baptist Health knew it needed to implement a new capture solution that would integrate with and complement its ECM Solution—CGI Sovera.
However, Baptist Health’s objectives for implementing a new capture solution were not limited to supporting the increase in data volumes. Baptist Health wanted to maintain, and even improve, its capture service levels. With medical record data (images) more readily available, Baptist Health could improve its coding turnaround time which, in turn, would expedite the revenue cycle—when bills are dropped and claims submitted.
With the new capture system, Baptist Health also wanted to continue to leverage its existing consolidated data capture site, increase staff productivity and reduce the number of FTEs required to support the operation.
After an extensive evaluation of available technology, Baptist Health selected a solution that combined two ibml ImageTrac® document scanners with CGI’s Sovera Capture solution.
The ImageTrac devices scan 429 pages per minute in color and black and white, and handle virtually any document type comingled. The scanners include an ink jet printer that sprays batch information on a batch cover; dual pockets to automatically out-sort document separator sheets for re-use; a full-color touch screen control panel; multi-feed detection; and barcode recognition.
The Sovera Capture solution uses predefined “rules” to increase the capture and indexing efficiency of patient and employee health. For instance, in the case of a record with a face sheet, the patient’s account number can be automatically extracted from the face sheet and applied to all subsequent documents. If the document includes a bar code, the solution automates the indexing. Documents without document-type bar codes are manually indexed. The software also includes a custom index interface with definable hot key and tab assignments to speed any manual indexing.
The first step in the implementation of the new capture solution was a visit to another user of CGI’s Sovera HIM and Sovera Capture solutions integrated with the high-speed scanners from ibml. Armed with ideas from this visit, Baptist Health then evaluated its existing capture processes, and analyzed its document types to identify likely exceptions scenarios. The objective for Baptist Health was to identify potential process improvements and document redesign opportunities early on in the process.
Next, the ibml scanners were installed and configured at Baptist Health, and the Sovera Capture software was integrated with their existing Sovera HIM solution. This step was followed by unit testing, operator training on the ibml scanners, and customized end-user (indexer) and supervisor training on the Sovera Capture software. Once user-acceptance testing was completed, Baptist Health went into production with the new solution at all of its document capture sites in April 2010, backed by “post go-live” support from CGI and ibml.
The implementation of the solution went so smoothly that Baptist Health was able to completely migrate from its legacy system in just 2 1/2 weeks—far less than the two month conversion period the health system had expected, according to Maria C. Alen, corporate Document Management System manager at Baptist Health.
Deploying the document capture system from ibml and CGI provided Baptist Health with significant benefits, including faster turnaround, lower costs, and enhanced service to both patients and staff.
The new document capture system enabled Baptist Health to reduce its turnaround time for getting records into its Sovera HIM system to just four hours from the time patients are discharged. With Baptist Health’s old document capture system, it took one to two days for patient records to be available electronically. Before upgrading to the new system, Alen’s staff was deluged with calls and e-mails asking when particular records would be available and staff would often need to request that specific records be expedited. What’s more, physicians frequently complained about what they perceived to be a slow turnaround. The faster turnaround has virtually eliminated inquiries regarding records availability.
“Faster turnaround impacts the patient continuum,” Alen said. “Physicians and nurses can access records sooner, and coding for billing can begin sooner. Faster turnaround reduces number of times records gets handled as they are not pending to be processed on a shelf for very long. This ensures the integrity of the medical records by shortening the time between discharge and processing of the medical records.”
The speed and efficiency of the document capture system also allowed Baptist Health to eliminate its second and third shifts for records management—even though the health system now processes more records than ever as a result of opening a new hospital and more urgent care facilities. In all, Baptist Health reassigned 25 full-time equivalents to other departments—representing a 50 percent reduction in its records management staff—since deploying the document capture system from ibml and CGI.
The immediate improvements in productivity delivered by the system enabled Baptist Health to begin reassigning employees from its records department just two months after deployment.
For instance, the barcode reading capabilities of the document capture system—which allows for the automatic indexing of records based on barcodes containing the patient’s account number—allowed Baptist Health to reduce the number of staff required for indexing from 16 to six. What’s more, the six remaining employees now split their time between indexing and quality assurance (QA) tasks, and are doing more QA today than before the solution was implemented.
Reducing the staff required for indexing allowed Baptist Health to consolidate the function into its main records management area, freeing space for other departments. “Bringing everyone into one space helped with team building, work monitoring, communication, and supervision,” Alen said.
The automated piggyback detection capability of the ImageTrac also eliminated the need for Baptist Health’s staff to count pages to ensure that there weren’t any piggybacks. With its old system, Baptist Health would count documents up to three times to prevent piggybacks from going undetected.
Similarly, the ImageTrac’s ability to process duplex and simplex items co-mingled means Baptist Health no longer has to physically sort these documents and place a separator sheet between them.
Reduced costs for supplies
Additionally, the ImageTrac’s ability to automatically out-sort separator sheets allows Baptist Health to re-use the documents for up to six months, typically when they start to wear out. Its old document capture system couldn’t out-sort separator sheets, meaning they couldn’t be re-used. Printing 300,000 separator sheets each month not only had an environmental impact, it cost the health system between $4,800 and $5,000 a month. Making matters worse, it was a hassle making sure that the department always had enough separator sheets available. Today, staff simply remove out-sorted separator sheets from the ImageTrac and stack them on a shelf for re-use. Since the health system requires fewer separator sheets, it now can print the document in-house and avoid third-party expenses.
Incredibly, the cost of supplies for Baptist Health’s two ImageTrac scanners are less than half the cost of the supplies required for its old scanners (Alen still cringes at the cost of the lamps they used).
Alen said the open-track design of the ImageTrac scanner also improves document tracking. “You never lose sight of documents on the ImageTrac,” she said. “This wasn’t the case with Baptist Health’s old scanners, that on occasion lodged documents within the scanner that would need careful removal,” Alen said.
The bottom line
At a time when healthcare organizations of all sizes are trying to balance requirements to electronify records with pressure to control operations costs, Baptist Health found an answer in a new capture solution.
“As a result of our document capture system from ibml and CGI, we are working faster, smarter, and more efficiently than ever,” Alen concluded. Not surprisingly, the system has generated tremendous interest throughout Baptist Health and the healthcare community. “Physicians, other departments and even other health systems are constantly calling us to ask for a tour,” Alen said.
“We are extremely pleased with our decision to deploy the ibml and CGI solution,” Alen said.